Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2002
Biography Historical ArticleEdward Tuohy: the man, his needle, and its place in obstetric analgesia.
The introduction of a needle designed by Ralph Huber and Edward Tuohy made continuous epidural anesthesia for labor possible. Neither the needle nor the regional anesthetic technique evolved in a vacuum; both were the culmination of a range of ideas developed by individuals around the world.
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Reg Anesth Pain Med · Sep 2002
Successful interscalene block with a nerve stimulator may also result after a pectoralis major motor response.
Interscalene block of the brachial plexus is a well-established anesthetic and analgesia technique for shoulder surgery. The endpoint for successful block using the nerve stimulator has been described by previous authors as a bicep motor response (twitch) and recently by a deltoid motor response. This retrospective observational case study of regular clinical practice examined the efficacy of using the pectoralis major motor response as an endpoint for a successful block. ⋯ This retrospective observational case study of regular clinical practice suggests that a pectoralis major motor response can be a satisfactory endpoint for interscalene block.
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Reg Anesth Pain Med · Sep 2002
Cyclooxygenase-2 inhibition potentiates morphine antinociception at the spinal level in a postoperative pain model.
After peripheral inflammatory stimuli, spinal cord cyclooyxgenase-2 (COX-2) mRNA and protein levels increase, whereas COX-1 is unchanged. In animal models of inflammatory pain, intrathecal COX-2 selective inhibitors suppress hyperalgesia. However, the role of spinal COX-2 inhibition in postoperative pain is not well elucidated. This study investigates whether a water-soluble COX-2 selective inhibitor, L-745337, can modify allodynic responses in a rat model of postoperative pain. ⋯ These results suggest a spinal interaction of COX-2 inhibition with opiate analgesia may allow a reduction of postoperative pain with lower doses of opiate.
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Reg Anesth Pain Med · Sep 2002
Comment Letter Historical Article"Santayana's prophecy fulfilled" requires a critique.